住院非手术患者工作日与非工作日血糖变异度差异研究

Glycemic variability on working days and non-working days in non-surgical inpatients with diabetes mellitus

关键词:  血糖变异度  血糖变异系数  工作日  非工作日  日间血糖变异

Key words:  glycemic variability  glycemic coefficient of variation  working days  non-working days  between-day glycemic variability

摘要:

目的探究工作日与非工作日血糖变异度（glycemic variability, GV）的差异。方法选取2020年1月1日—2020年12月31日在复旦大学附属中山医院厦门医院内分泌科住院且应用血糖管理系统记录住院期间血糖情况的非手术患者，由营养科经系统记录提取所有接受血糖监测的人员名单后加以筛选，入选患者计算工作日与非工作日血糖变异系数（coefficient of variation, CV），并行相关对比。结果共入选232例患者，血糖均值的平均值为（9.58±1.71） mmol/L，血糖标准差的均值为（2.92±0.90） mmol/L，血糖CV的均值为（30.32±6.71）%。工作日血糖CV较非工作日血糖CV大（P<0.001）。按工作日血糖CV是否大于等于非工作日分组，唯一具有统计学差异的是胰岛素应用组（P=0.044）。按工作日与非工作日血糖CV差值绝对值的中位数分组，尿白蛋白肌酐比值（P=0.046）、HbA1c（P=0.001）两组具有存在显著差异。结论住院非手术患者工作日血糖CV比非工作日大，且二者血糖CV相差越大，合并有越多的靶器官损害。

Abstract:

ObjectiveTo explore the difference in glycemic variability（GV) between working days and non-working days in non-surgical inpatients with diabetes mellitus. MethodsA total of 232 non-surgical diabetic patients admitted in Department of Endocrinology, Xiamen Branch of Zhongshan Hospital from January 2020 to December 2020 were enrolled in the study. The blood glucose levels of patients were documented with the blood glucose management system during the hospitalization period. The coefficient of variation（CV) of blood glucose levels were calculated and compared between working days and non-working days. ResultsThe average blood glycemic level was （9.58±1.71) mmol/L, the average of glycemic standard deviation was （2.92±0.90) mmol/L, and the average of glycemic CV was （30.32±6.71)%. The CV of working days was larger than that of non-working days（P<0.001). According to whether the CV of working days was greater than or equal to non-working days, the only statistical difference is the insulin application group（P=0.044). Grouped by the median absolute value of CV difference between working days and non-working days, there were significant differences in the urine albumin/creatinine ratio（P=0.046) and glycosylated hemoglobin（P=0.001). ConclusionCV of working days is greater than that of non-working days, and the glycemic variability is associated with the degree of target organ damage.